<form action="{$apm.ssl.baseurl}search/requestsearch/conditions/" id="usrform" name="usrform" method="post">
<div id="containerInner" class="easyrequest">
<div id="container">
<div id="contentHeader">
<p class="lead">部屋探し情報なら賃貸情報が満載のアパマンショップ。賃貸マンション・賃貸アパートの情報を多数掲載。</p>

<ol class="topic_path">
<li><a href="{$apm.baseurl}">賃貸情報</a></li>
<li><strong>お客様情報</strong></li>
</ol>
</div>

<div id="wrapper">
<div id="contentMain" class="easyrequest_user">

<div class="box_head_easyrequest">
<h1><img src="/static/requestsearch/images/ttl_user.png" width="624" height="145" alt="探して！べあ～君"></h1>
<p><img src="/static/requestsearch/images/ttl_request.gif" alt="非公開物件や掲載前の物件も!! かんたんリクエスト" width="439" height="70"></p>
<span class="bear"><img src="/static/requestsearch/images/ttl_bear_user.gif" width="729" height="253" alt="伝えて待つだけ べあ～"></span>
<!-- /.box_head_easyrequest --></div>

<div class="lead">
<p class="status"><img src="/static/requestsearch/images/img_status_user.gif" width="1000" height="60" alt="お客様情報"></p>
<!-- /lead --></div>

<div class="mod_box_section_bdt">
<table>
<tr class="bdr_none bg_none">
<td colspan="2" class="announce"><div id="sfs-facebook-button"></div></td>
</tr>
<tr>
<th id="titleName"><p>お名前<span>必須</span></p></th>
<td>
<ul id="nameerr" class="error" style="display:none;">
</ul>
<ul>
<li><span>姓</span><input name="NameSei" id="NameSei" type="text" placeholder="例）賃貸" value="{$NameSei}" class="w_1 sei"><span>名</span><input name="NameMei" id="NameMei" type="text" class="w_1" placeholder="例）太郎" value="{$NameMei}">※全角</li>
<li><span>セイ</span><input name="NameSeiKana" id="NameSeiKana" type="text" placeholder="例）チンタイ" value="{$NameSeiKana}" class="w_1 sei"><span>メイ</span><input name="NameMeiKana" id="NameMeiKana" type="text" placeholder="例）タロウ" value="{$NameMeiKana}" class="w_1">※全角カタカナ</li>
</ul></td>
</tr>
<tr>
<th id="titleRenraku"><p>ご連絡方法<span class="which">いずれか必須</span></p></th>
<td>
<ul id="renrakuerr" class="error" style="display:none;">
</ul>
<ul>
<li>メールアドレス<br>
<input name="Mail" id="Mail" type="text" placeholder="例）henshinchintai@apamanshop.co.jp" value="{$Mail}" class="w_2">※半角英数字</li>
<li>電話番号<br>
<input name="Tel" id="Tel" type="text" placeholder="例）0312345678" value="{$Tel}" class="w_2">※半角（ハイフンなし）</li>
</ul></td>
</tr>
<!-- 20150117 S_Add -->
<tr>
<th><p>キャンペーン応募</p></th>
<td><ul>

{foreach from=$CAMPAIGNS item=c name=campaigns}
<li><label><input name="campaign{$smarty.foreach.campaigns.index}" type="checkbox" value="{$c.M94_CAMPAIGN_CD}"{$c.checked}/>{$c.M94_CAMPAIGN_NAME}</label>　<a href="http://www.apamanshop.com{$c.M94_CAMPAIGN_URL}" target="_blank" class="mod_link_arrow mod_link_arrow_blue">詳細</a></li>
{/foreach}
</ul></td>
</tr>
<!-- 20150117 E_Add -->
</table>
<!-- /.mod_box_section_bdt --></div>

<p class="btn_entry"><a id="btnNext" href="javascript:void(0)" class="mod_btn_l mod_btn_all_blue">ご希望条件の入力へ</a></p>

<!-- /#contentMain --></div>
</div>
</div>
</div>
<div id="push"></div>
{$hiddenTag}

</form>